HIV isn’t a genetic disease, but your genes may affect your risk of contracting the virus if exposed. Even though genetics aren’t involved, a birthing parent can pass it on to their child in several ways.

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Human immunodeficiency virus (HIV) is a virus that affects the immune system. You contract HIV by coming in contact with bodily fluids that contain the virus. Such fluids include:

  • blood
  • semen
  • vaginal and rectal fluids
  • breast milk

Because HIV is a virus, it’s not a genetic disease — at least not in the same way as other genetic diseases.

Genetic disorders like sickle cell anemia or cystic fibrosis occur because of the genes you inherit. Other diseases, like cancer, cause changes to your genetic material, which can sometimes be passed on to future generations.

HIV doesn’t do either of these things. However, because of how the virus works, it inserts its own genetic material into yours. Research also suggests that your genetics may affect how likely you are to contract HIV if exposed to the virus.

This article explores how HIV is related to genetics and how it can pass from parent to child.

If a condition is hereditary, it means it passes from parent to child when the child receives genetic information from their parents.

HIV does not pass from parent to child this way, so it is not hereditary.

Even though people don’t pass on HIV through their genes, there are still ways a parent can pass it on to their child. More on that later.

Different factors influence your risk of getting HIV. Exposure to the virus is most important, and certain behavioral and sociodemographic factors may play a role in the risk of exposure.

But a 2020 study also suggests that up to 42% of your susceptibility to HIV may be due to genetics.

Researchers found evidence that a mutation in a specific gene (EFCAB14) may increase your risk of acquiring HIV. However, the study only included people of European ancestry.

An earlier 2017 study involving sub-Saharan Africans identified two rare gene mutations that could affect HIV risk. A mutation in the CD101 gene increased risk by 2.7 times, while a mutation in the UBE2V1 gene increased risk by 3.7 times.

Some genes might also protect against HIV. Research from 2018 found that having two copies of the delta-32 allele (or form) of the CCR5 gene offered slight protection against HIV infection. However, the study was quite limited, and the results were not statistically significant.

Interestingly, the CCR5 gene mutation may also help protect against smallpox but increase the risk of COVID-19, according to 2022 research.

Viruses are little more than a small bit of genetic material enclosed in a viral envelope. They don’t possess the parts of a cell that allow living organisms to replicate. This means viruses need a host — you — to replicate.

A virus typically hijacks the parts of a cell that allow it to reproduce its own genetic material. But HIV is a specific type of virus called a retrovirus. It works a little differently.

Retroviruses have an enzyme that can splice open your DNA and insert their own DNA in between. This viral DNA, now incorporated into your DNA, is called a provirus. When the affected cell goes through its regular process of transcribing DNA to make proteins, it transcribes the viral DNA, causing the cell to make new copies of the virus.

So, HIV integrates itself into your DNA, but only in the cells it can attack. HIV usually attacks a type of immune cell called a CD4 cell.

You don’t pass down DNA changes in a CD4 cell to your children. The DNA you pass on to your children comes from egg and sperm cells.

But don’t sperm cells carry HIV?

You can transmit HIV through your semen. But semen is more than just sperm cells. It contains many other substances and cell types, including CD4 cells. It can also contain free-floating HIV.

Gene therapy seeks to replace disease-causing genes with healthy genes. Scientists are researching the potential benefits of gene therapy in genetic conditions like hemophilia and sickle cell anemia. It may also help treat certain cancers.

Scientists have also thought about how gene therapy might help treat HIV. One method involves extracting CD4 cells, removing the viral DNA, and restoring healthy CD4 cells to the body. Other techniques involve genetically engineering new HIV-resistant immune cells to replace infected cells.

But these techniques have proven challenging and are yet to yield a cure. Still, the research is promising, and scientists continue to refine their methods to find a cure.

While HIV isn’t passed down through genetic material, a birthing parent can transmit the virus to their child. This is called perinatal (or vertical) transmission.

There are three ways in which a birthing parent with HIV can pass it on to their child:

  • Crossing the placenta: The placenta is an organ that forms within a uterus during pregnancy. It delivers nutrients to the fetus and helps protect it against infection. HIV weakens this protection, and the virus may cross the placenta.
  • Fluid exchange: A baby may come in contact with blood or other fluids from a birthing parent during labor or delivery.
  • Breast milk: A parent with HIV can transmit the virus through their breast milk. But the risk is less than 1% if the parent is on antiretroviral therapy.

Can a biological father pass on HIV to their child?

A biological father cannot pass on HIV to a fetus. There are isolated cases of accidental transmission immediately after birth, but these are extremely rare.

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According to the National Institutes of Health, you may consider the following steps to help reduce the risk of transmitting HIV to your baby:

  • Testing: Undergo testing for HIV as soon as possible after you know you are pregnant.
  • Antiretroviral therapy (ART): ART can reduce the amount of virus in your body and reduce the risk of transmission. A doctor will likely also recommend ART for the baby for a few weeks after birth.
  • Cesarean delivery: A cesarean delivery, commonly called a C-section, may reduce the risk of HIV transmission during delivery. However, 2017 research suggests that the risk reduction may not be significant and that cesarean delivery comes with other risks.
  • Bottle feeding: Even though the risk of transmission through breast milk is small if you’re on ART, there’s zero risk if you use formula.

HIV integrates itself into the DNA of your immune cells, but it’s not a genetic disease. You can’t pass it on to your children via your genetic material. But a birthing parent can transmit the virus to a child during pregnancy, delivery, or breastfeeding.

Talk with a doctor if you have HIV (or suspect you might have it) and are expecting or planning to have a baby. They can suggest a treatment plan to minimize the risk of transmission to your newborn.